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General NPI Number Information
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NPI Number | 1003937913
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Entity Type | Organization
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Legal Business Name | DANIEL D. MATHEWS DPM PC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 4035 95TH ST LOWER LEVEL
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City | ELMHURST
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State | NY
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Zip | 11373-6200
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Country | US
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Telephone | 718-205-6201
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Fax | 718-205-5664
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Provider Business Mailing Address
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Address Line | 4035 95TH ST LOWER LEVEL
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City | ELMHURST
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State | NY
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Zip | 11373-6200
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Country | US
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Telephone | 718-205-6201
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Fax | 718-205-5664
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL DEFAZIO MATHEWS
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Credential | D.P.M
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Telephone | 718-205-6201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 004379
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License Number State | NY
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